HYBRID EVENT: You can participate in person at Madrid, Spain or Virtually from your home or work.

5th Edition of Cardiology World Conference

September 5-7, 2024 | Madrid, Spain

September 05 -07, 2024 | Madrid, Spain
Cardio 2023

Yasir Bakhit

Yasir Bakhit, Speaker at Cardiovascular Conference
Oxford University Hospitals NHS Trust, United Kingdom
Title : Sodium channelopathy with an overlap of brugada syndrome, paroxysmal atrial fibrillation, and progressive cardiac conduction system dysfunction


Background: Brugada syndrome is a rare diagnosis with a prevalence of 3 to 5 per 10,000, accounting for 4% of all sudden cardiac deaths. It can present with ventricular tachyarrhythmia and sudden cardiac deaths in structurally normal hearts, with an autosomal dominant pattern of inheritance. To diagnose it an ECG showing Brugada type 1 pattern with other clinical features is required. Different genes have been associated with disease, the commonest being voltage-gated sodium channel alpha type V gene (SCN5A).(1)
Case summary: We present a 21-year-old man who had 2 admissions from a local prison following a successfully resuscitated cardiac arrest. AED rhythm strip confirmed an underlying VF. The diagnosis of Brugada was based on both the ECG findings and the presentation of cardiac arrest. His ECG revealed coved ST changes in V1-2 and J waves at the inferolateral QRS complexes suggestive of Brugada pattern.  Overlap of progressive cardiac conduction system dysfunction on top of the significant sodium channelopathy was due to the finding of prolonged first-degree AV block with paroxysmal atrial fibrillation. A Cardiac MRI showed a structurally normal heart. Isoprenaline infusion was intitiated and the amiodarone and beta-blocker therapy were stopped. Then transitioned to oral Quinidine sulphate (600mg bd) therapy with excellent effect. Inferolateral J waves disappeared and Quinidine-induced QT prolongation remained manageable. He displayed evidence of AV conduction disease with PR prolongation. A dual-chamber ICD was implanted for secondary prevention of arrhythmic death. He was then discharged back to his home, having completed his term in prison. Home monitor did not transmit any issues with his ICD, and his ICD checks were satisfactory. ICC clinic follow-up happened four months post-discharge, patient had no further events and remained asymptomatic. His ECG showed considerable improvement, PR interval was down to 200ms with a hint of type 1 Brugada-pattern in lead V1.
Conclusion: Reaching to a correct diagnosis and consulting the appropriate experts led to best possible outcome for the patient by having an Implantable Cardioverter Defibrillator (ICD) implanted, therefore preventing sudden cardiac deaths.


Dr Yasir Bakhit Cardiology Registrar at Oxford University Hospitals NHS Trust - John Radcliffe Hospital. He have worked in Cardiology since 2017 after completing my Core Medical Training. He is a member of the Royal College of Physicians (MRCP). He have a special interest in arrhythmias, devices and heart failure. His cardiology publications include Exercise-induced RV cardiomyopathy in an endurance cyclist, published in the European Heart Journal, as well as a Case report and literature review on contrast-induced encephalopathy published in Future Cardiology Journal and a poster presentation on "Unstable angina prior to presentation with STEMI: insights from a 'real-world' series of patients undergoing PPCI.